Suicides More Common than Traffic Deaths

Suicide has overtaken motor vehicle crashes as the leading cause of injury deaths in the U.S., a national study found.

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Suicide has overtaken traffic accidents as the leading cause of injury deaths in the U.S.

Note that deaths from poisoning and falls also rose substantially from 2000 through 2009.

Suicide has overtaken traffic accidents as the leading cause of injury deaths in the U.S., a national study found.

The suicide rate rose 15% over the past decade, while unintentional motor vehicle crashes fell 25%, Ian R.H. Rockett, PhD, MPH, of the West Virginia University School of Public Health in Morgantown, and colleagues found.

Deaths from poisoning and falls also rose substantially from 2000 through 2009, the group reported online in the American Journal of Public Health.

"Comprehensive and sustained traffic safety measures have apparently substantially diminished the motor vehicle traffic mortality rate, and similar attention and resources are needed to reduce the burden of other injury," they wrote.

Eliminating fatal injuries might raise the national life expectancy by 1 to 2 years, "but it would extend the mean length of life of those whose deaths were averted by a projected 3 decades," they added.

The researchers analyzed data on cause of death from the CDC's National Center for Health Statistics for patterns and trends in fatal injury from 2000 through 2009.

Overall, combined unintentional and intentional injury mortality rose 10% over this period from 53 to 56 per 100,000 population after adjustment for trends in age.

The adjusted total injury death rate fell 78% in the youngest age group -- those 14 and under, while the 75 and older group had a 2.8-fold increase. Total injury death rates rose more among females and whites than among other groups.

The five leading causes of injury deaths accounted for an increasing proportion, up from 77% to 82% over the study period.

Shifts occurred within the list as well.

Suicide took over from motor vehicle accidents as the leading cause of injury death in 2009, with an age-adjusted rate of 12 per 100,000 population in that year.

Motor vehicle crashes remained in second place with an age-adjusted rate of 11 per 100,000.

"Our finding that suicide now accounts for more deaths than do traffic crashes echoes similar findings for the European Union, Canada, and China," Rockett's group noted.

Poisoning rose the most among the injury-related causes of death. The 128% increase from 2000 to 2009 bumped homicide out of third place in 2003.

These deaths were largely accounted for by overdoses of prescription drugs, particularly opioid analgesics.

Tackling fatal overdoses may take a multi-pronged approach, the investigators noted.

"Several promising prevention and control strategies have recently been implemented, including Prescription Drug Monitoring Programs, the Food and Drug Administration's Opioid Drugs and Risk Evaluation and Mitigation Strategies, provider prescribing guidelines, and single provider-single pharmacist 'lock-in' programs," they wrote.

Falls also surpassed homicide in 2004 to become the fourth most common cause of injury deaths at a rate of 7 per 100,000 in 2009, which reflected a 54% increase since 2000.

The increase in fall-related deaths was greater with older age and disproportionately affected men and whites.

Homicide ended up as the fifth leading cause of injury deaths, with an 8% decline to an age-adjusted rate of 5 per 100,000 in 2009.

Limitations of the study were largely due to the quality of the information recorded on the death certificate, which could have been influenced by differential reporting stemming from "variable training, resources, philosophies, procedures, and practices of medical examiners and coroners," Rockett's group cautioned.

Distinguishing intentional from unintentional injury is also a challenge, they noted.

The study was supported in part by grants from the CDC and the National Institute on Alcohol Abuse and Alcoholism.

Reviewed by Robert Jasmer, MD Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner

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